Is indoor tanning safe?

Indoor tanning is becoming increasingly popular among American women. In a typical community, it’s easier to find a tanning salon than a McDonald’s.

As always, appearance is a major reason for tanning. Our culture is still obsessed with the idea of a “healthy tan.” In addition, many women apparently use tanning to reduce stress. In a survey of 706 female students at the University of North Carolina, 45 percent said they had used a tanning salon and that they considered it a positive experience, reducing stress and enhancing mood.

Indoor tanning increases cancer risk

What they may have known – but didn’t mention – is that their time in the tanning booth puts them at increased risk of all three types of skin cancer, including often-fatal malignant melanoma.

The tanning industry, to be sure, argues that tanning beds are safer than outdoor tanning or burning. But, the evidence doesn’t support their claims. Results from the Minnesota Skin Health Study in 2010 found an increased risk of melanoma among women who’d ever tanned indoors, with the greatest risk among those who used tanning beds most frequently. And a later study, directly comparing indoor and outdoor exposure to ultraviolet radiation, found a greater risk of melanoma indoors.

Regardless of outside exposure, subjects who had used tanning devices for 1 to 9 hours over their lifetime had a 46 percent increased risk, while those exposed for 50 or more hours had a three-fold increased risk.

UVA and UVB rays

Sunlight contains ultraviolet A (UVA) and ultraviolet B (UVB) rays. UVB can be blamed for most sunburns. UVA is better for tanning. UVA rays have long been associated with wrinkling and skin aging. But, until recently, they weren’t believed to be a major factor in skin cancer.

Repeated exposure to UVA damages the skin’s DNA, however, and these mutations have been clearly linked to cancer. Tanning is an effort by the body to prevent further damage. Tanning booths emit mostly UVA. The theory, according to the tanning industry, is that this will produce a “base tan” to keep you from burning when you hit the beach. Don’t believe it for a minute. The Minnesota Skin Health Study found a stronger association between indoor tanning and melanoma – not only in machines emitting higher amounts of UVD – but also in those emitting almost exclusively UVA rays.

Tanning associated with three types of skin cancer

All three types of skin cancer are associated with both indoor and outdoor exposure to ultraviolet radiation. Basal cell carcinoma, the most common but least harmful skin cancer, is likely to show on areas most exposed to the sun over a lifetime, such as the face and hands.

Squamous cell carcinomas are more likely to grow into deeper layers of skin. Both basal and squamous cell cancers grow slowly and rarely spread to other areas of the body. Melanoma, developing in the pigment-producing cells, does spread and is one of the most harmful cancers.

A study published in 2012 concluded that indoor tanning before age 35 increases the risk for melanoma by 75 percent. “Given the high prevalence of indoor tanning among young adult women,” the authors wrote, “an increased focus should be placed on this population to prevent melanoma from increasing significantly as this generation ages.”

Warnings required for minors

In May, 2014, the Food and Drug Administration re-classified sunlamp products used in tanning salons as moderate-risk devices, requiring a black box warning for consumers younger than 18. Some states, cities and counties have banned tanning by minors under age 18, but restrictions aren’t always strictly enforced. If tanning is allowed with a parent’s permission, it is often granted, particularly if the parent also uses tanning parlors.

Just say no

Like smoking, tanning is an acquired behavior that brings pleasure and reduces stress. Both are habits that are hard to break and potentially deadly. Whether it takes willpower or some additional help, it’s important to just say no.

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